The purpose of this article is to explain a novel method for conducting research at the community level, using a new approach called Asset Mapping Score Analysis (AMSA). The AMSA design was used to assess MCH organizations in New Orleans and the results of that study are presented here. Researchers and public health officials can apply this new methodology to other topics in different geographic locations. Asset mapping approaches have existed for almost thirty years, and have been employed in multiple countries, in regions ranging from rural to urban, and applied to a diverse array of topics in public health, medicine, social work, economics, and other social and behavioral sciences [31–40]. Asset mapping methods have unique benefits and offer distinct advantages that needs mapping alone cannot provide [41, 42]. Despite the longevity and utility of this tool, there have been few attempts to develop structured and reproducible protocols for conducting asset mapping studies. The purpose of this project is to describe a new method that others can use to conduct their own asset mapping studies.
A recent scoping review by Luo and colleagues provides a thorough summary of the origins and evolution of asset mapping along with several example studies [3]. This work suggests there is a large variation in the methodological rigor of some asset mapping studies. As such, a well-defined and reproducible method, such as the AMSA approach, may be useful to provide a robust tool that can be used to strengthen the quality of real-world evidence collected by asset mapping projects.
Our AMSA tool uses a novel framework in which both functional areas (education, direct services, research, and policy/advocacy) and content areas were evaluated. This provides richer data that may be used in combination with outcomes data, survey data, or other results to provide a holistic knowledge base of the strengths, weaknesses, opportunities, and threats of the New Orleans MCH field. Furthermore, this novel approach may supplement other forms of data to provide insights that can be used to inform policy recommendations, program planning and budgeting, or new research questions for MCH organizations.
This analysis found that the MCH functional area with the most asset mapping points was education (375 points), and the one with the least was research (108 points). The content areas with the most asset mapping points were mental health, social and behavioral health, and maternal/preconception/postpartum care. The content areas with the fewest asset mapping points were oral health, child protection or foster care, and vaccination. While MCH outcomes have been well-studied and documented in New Orleans, there is a knowledge gap in recording which organizations are doing what work. This may result in inefficiencies where several organizations are working on the same problems but are not collaborating. Asset mapping may therefore reduce these redundancies and help organizations work together on similar efforts. Additionally, such mapping can identify (mis-)alignment between assets and resources.
This methodology has several strengths. First, by differentiating functional areas from service areas, resources can be described and quantified in novel ways. For example, to the authors’ knowledge, no one has ever previously characterized or quantified MCH organizations in New Orleans allowing for a more comprehensive assessment of the MCH resources available in the area. Second, AMSA is highly flexible. Users could change the functional and content areas under study to better suite their project goals. Third, AMSA is inexpensive and can be used to study complicated topics even in resource-limited settings. The largest costs associated with this study were staff wages and technologic resources. It is reasonable to conclude that this approach could be scaled up to study larger samples in greater geographic areas at a relatively low cost. Fourth, AMSA data can be combined with other methods, like needs mapping, survey studies, and financial or economic studies. Finally, the AMSA study can be repeated over time to detect changes in the communities longitudinally.
This method also has key limitations. Most importantly, AMSA data is not a direct measure of outcomes. For example, in this assessment of MCH resources in New Orleans, the content area with the most asset mapping points was mental health. However, it is difficult to determine if the high number of points is because there is a robust mental health support system in the study population, or if it reflects a significant burden of mental health morbidity. Likewise, the number of asset mapping points for any content area is a measure of the total number of organizations working in that content area among all four functional areas, and therefore, does not reflect the volume of work being done by a single organization. For example, a content area with a low number of points, such as vaccination, may be handled by only a few organizations, but those organizations may have a high degree of coverage. Furthermore, some consideration must be given to the fact that points were determined by organization self-report. While self-report was important because it allowed organizations to select all the work that organizations do in functional or content areas, it is also possible that differences in interpretation or definitions may have affected these results. Finally, the response rate for our questionnaire was 65.1%. It is difficult to determine how the findings of this project may have changed with a higher response rate.
The AMSA method can be applied to other geographic locations and fields of study as a tool to better understanding the work being done in those contexts. The information obtained via this methodology can be combined with the other data from traditional models to expand the body of knowledge. Other researchers, program planners, or service providers could use a similar framework to describe the functional areas and content areas that are relevant in their field and adapt the methods to suit their needs in terms of describing the pertinent strengths or weaknesses unique to their situation. Furthermore, because this framework is flexible, future users can focus on the components that are most important to them. Other users may add factors such as the organizations’ budgets, eligibility criteria, number of clients reached per unit time, partner organizations, or geographic information. Future work may find the AMSA method to be a valuable tool in other contexts because it provides information that needs mapping and outcomes research cannot. It is flexible and can incorporate quantitative, qualitative, and geographic data, and can be easily modified to meet the specific needs of the users.
Table 1
Functional and content areas of New Orleans Maternal and Child Health organizations
| Functional area (number of organizations) | |
Content area | Education | Direct Services | Research | Policy and/ or Advocacy | Total Points |
Breastfeeding | 15 | 10 | 4 | 11 | 40 |
Child protection and foster care | 9 | 3 | 0 | 7 | 19 |
Childbirth/birth outcomes | 18 | 6 | 8 | 14 | 46 |
Developmental screening | 9 | 8 | 2 | 4 | 23 |
Early childhood education/school readiness | 17 | 7 | 5 | 10 | 39 |
Family planning and reproductive health | 22 | 7 | 7 | 15 | 51 |
Health insurance/access to care | 16 | 6 | 5 | 14 | 41 |
Health/medical care | 19 | 12 | 7 | 14 | 52 |
Home visiting | 7 | 17 | 3 | 8 | 35 |
Infant Health, including safe sleep | 16 | 8 | 5 | 8 | 37 |
Injury and violence prevention | 13 | 9 | 6 | 11 | 39 |
Maternal/preconception/postpartum care | 21 | 15 | 7 | 14 | 57 |
Mental Health | 33 | 20 | 14 | 21 | 88 |
Nutrition and food assistance | 25 | 16 | 5 | 9 | 55 |
Oral Health | 9 | 3 | 1 | 4 | 17 |
Physical activity | 18 | 13 | 6 | 8 | 45 |
Sexual health | 23 | 9 | 6 | 11 | 49 |
Social and behavioral health | 31 | 24 | 8 | 11 | 74 |
Social/community services (including legal and financial assistance) | 19 | 15 | 2 | 9 | 45 |
Special needs | 10 | 7 | 1 | 5 | 23 |
Tobacco, alcohol, and drug use | 16 | 8 | 4 | 7 | 35 |
Vaccination | 9 | 3 | 2 | 6 | 20 |
Total Points | 375 | 226 | 108 | 221 | 930 |